nursing standard: clinical · research · education
Spiritual care in nursing: a systematic approach
Govier I (2000) Spiritual care in nursing: a systematic approach. Nursing Standard. 14, 17, 32-36. Date of acceptance: November 11 1999.
Ian Govier MSc, BN, DipN, RGN, PGCE, RNT, is Charge Nurse/Ward Manager, Powys Ward, Welsh Regional Burns Unit, Morriston Hospital, Swansea NHS Trust.
Ian Govier suggests that patients will benefit if nurses adopt a systematic approach to assessing spiritual needs. However, it may be necessary to evaluate personal spirituality before applying this approach.
and encourage continued theoretical development to further our understanding of the concept and ultimately guide practice. In response to this call to promote nurses’ understanding of spiritual care, guidelines for the assessment of spiritual needs are presented as part of a systematic approach to nursing care.
Defining spiritual care
s Patients: attitudes and perceptions s Spiritual care s Care planning These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
HE TERM holistic care in nursing is one that many nurses who have trained or undergone further nurse education in the past decade will be familiar with (Harrison 1993, Narayanasamy 1996, Oldnall 1996). Indeed, many nurses will probably claim to have a commitment to the concept of holistic care, in that they will recognise the importance of considering the physical, psychological/emotional, social, cultural and spiritual aspects of need and care (Dossey and Dossey 1998, Stoter 1995). There is evidence to suggest that the first four of these needs are recognised, taught and practised in nursing curricula and care (McSherry and Draper 1997, Narayanasamy 1993, Ross 1995 and 1996), but the area of spiritual care is one that is frequently overlooked and delegated to a religious leader. This is often addressed within the framework of nurse education by the hospital chaplain or occasionally a tutor with a particular interest in spiritual matters. Although colleges of nursing are attempting to rectify this apparent omission by revising existing curricula and incorporating spiritual care, one may argue that many are still reluctant to recognise its relevance and importance (Govier 1999a, Harrison and Burnard 1993, Johnson 1998). The hesitancy displayed by nurse educationalists may suggest that a degree of suspicion, misconception and ambiguity still surrounds the spiritual dimension. Furthermore, given nursing’s apparent preoccupation with establishing itself as a scientific and research-based profession, the metaphysical dimension of spiritual care is not one that lends itself easily to scientific scrutiny. Considering that the dominant paradigm at this time supports the scientific model, it is not surprising that nursing has followed suit in its quest to gain greater credibility among the more established health disciplines which claim that practice is based on a rigorously tested theoretical foundation. Martsolf and Mickley (1998) highlight the void surrounding spirituality in nurse education
In an attempt to further clarify what is understood by spiritual care, and following extensive review of the literature, Govier (1999b) has summarised the concept as the ‘five Rs of spirituality’ (Box 1): s Reason. s Reflection. s Religion. s Relationships. s Restoration. Reason and reflection The search for meaning in life experiences has been viewed as an essential universal trait (Cobb and Robshaw 1998, Carson 1989, Highfield and Cason 1983, Murray and Zentner 1989, Stoter 1995, Thompson 1996). Indeed, the view of the renowned psychiatrist Viktor Frankl (1984) is that man’s primary motivational force is the search to find meaning and purpose in life experiences, whether they be in ordinary or extreme circumstances. Patients and carers often...
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